{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T08:12:22Z","timestamp":1788595942674,"version":"build-2803163510"},"reference-count":16,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,15]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. The physiological cardiovascular changes of pregnancy may worsen right-to-left shunting and haemodynamic instability in women with uncorrected TOF, increasing maternal and fetal risk. We report a case series of three parturients with uncorrected TOF managed at our institution using a combined low-dose spinal and epidural anaesthetic technique. In these cases, the technique was associated with adequate surgical anaesthesia and stable haemodynamics, allowing avoidance of general anaesthesia.<\/jats:p>","DOI":"10.1136\/bcr-2025-270807","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:35:18Z","timestamp":1788593718000},"page":"e270807","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Neuraxial anaesthesia for lower segment caesarean section in three parturients with uncorrected tetralogy of Fallot"],"prefix":"10.1136","volume":"19","author":[{"given":"Kirtika","family":"Yadav","sequence":"first","affiliation":[{"name":"Anaesthesiology, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8933-3295","authenticated-orcid":false,"given":"Shashank","family":"Kumar","sequence":"additional","affiliation":[{"name":"Anaesthesia, King George Medical College, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9088-6242","authenticated-orcid":false,"given":"Shreya","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Anaesthesiology, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neel Kamal","family":"Mishra","sequence":"additional","affiliation":[{"name":"Anaesthesiology, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2026090500500873000_19.9.e270807.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60657-7"},{"key":"2026090500500873000_19.9.e270807.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(78)90941-4"},{"key":"2026090500500873000_19.9.e270807.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-019-2630-y","article-title":"Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study","volume":"19","author":"Wang","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026090500500873000_19.9.e270807.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy340"},{"key":"2026090500500873000_19.9.e270807.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000458"},{"key":"2026090500500873000_19.9.e270807.6","doi-asserted-by":"crossref","first-page":"e657","DOI":"10.1161\/CIR.0000000000001121","article-title":"Anesthetic Care of the Pregnant Patient With Cardiovascular Disease: A Scientific Statement From the American Heart Association","volume":"147","author":"Meng","year":"2023","journal-title":"Circulation"},{"key":"2026090500500873000_19.9.e270807.7","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.bjae.2020.03.003","article-title":"General anaesthesia in obstetrics","volume":"20","author":"Delgado","year":"2020","journal-title":"BJA Educ"},{"key":"2026090500500873000_19.9.e270807.8","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1016\/j.ajog.2025.05.018","article-title":"Neuraxial anesthesia and pain management for cesarean delivery","volume":"233","author":"Landau","year":"2026","journal-title":"Am J Obstet Gynecol"},{"key":"2026090500500873000_19.9.e270807.9","doi-asserted-by":"crossref","first-page":"320","DOI":"10.4103\/1658-354X.84111","article-title":"Low-dose sequential combined-spinal epidural anesthesia for Cesarean section in patient with uncorrected tetrology of Fallot","volume":"5","author":"Solanki","year":"2011","journal-title":"Saudi J Anaesth"},{"key":"2026090500500873000_19.9.e270807.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2005.01.001"},{"key":"2026090500500873000_19.9.e270807.11","doi-asserted-by":"crossref","first-page":"244","DOI":"10.4103\/0259-1162.108358","article-title":"Anesthetic management of a parturient with uncorrected tetralogy of Fallot for Cesarean section","volume":"6","author":"Juwarkar","year":"2012","journal-title":"Anesth Essays Res"},{"key":"2026090500500873000_19.9.e270807.12","doi-asserted-by":"crossref","first-page":"315","DOI":"10.5152\/TJAR.2022.21388","article-title":"Management of an Uncorrected Tetralogy of Fallot for Caesarean Section Using Low-Dose Combined Spinal Epidural Anaesthesia Under Advanced Haemodynamic Monitorization","volume":"50","author":"Camgoz Eryilmaz","year":"2022","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"2026090500500873000_19.9.e270807.13","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1213\/ANE.0000000000002243","article-title":"Prophylactic Norepinephrine Infusion for Preventing Hypotension During Spinal Anesthesia for Cesarean Delivery","volume":"126","author":"Ngan Kee","year":"2018","journal-title":"Anesth Analg"},{"key":"2026090500500873000_19.9.e270807.14","doi-asserted-by":"crossref","first-page":"104891","DOI":"10.1016\/j.ijoa.2026.104891","article-title":"Uterotonics in pregnant patients with cardiac disease: a focused review","volume":"66","author":"Pradhan","year":"2026","journal-title":"Int J Obstet Anesth"},{"key":"2026090500500873000_19.9.e270807.15","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14757"},{"key":"2026090500500873000_19.9.e270807.16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.5005\/jp-journals-10006-2329","article-title":"Pregnancy Outcome in Cases of Uncorrected Tetralogy of Fallot: Case Series with Review of Literature","volume":"16","author":"Sachdeva","year":"2024","journal-title":"J South Asian Fed Obstet Gynaecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270807","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:50:21Z","timestamp":1788594621000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,4]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2025-270807"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270807","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}